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General NPI Number Information
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NPI Number | 1700343084
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Entity Type | Individual
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Provider Name | THOMAS THO NGO RPH
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Gender | Male
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Dates
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Enumeration Date | 02/22/2019
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 609 OMACHE DR
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City | OMAK
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State | WA
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Zip | 98841-9672
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Country | US
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Telephone | 509-826-2806
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Fax |
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Provider Business Mailing Address
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Address Line | 107 JONATHAN AVE E
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City | OMAK
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State | WA
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Zip | 98841
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Country | US
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Telephone | 206-349-1231
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60774490
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License Number State | WA
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